To wonder what's happened to the NHS?

[Chefpig]

I went for surgery this afternoon. Waited three hours in a waiting room because there were no beds available. Uncomfortable, especially with pain, but couldn't be helped.

I expressed a wish to the anaesthetist for GA after much trauma from a attempted and failed spinal anaesthetic in the past. Anaesthetist told me that a spinal would be much better for recovery and I should at least trust them and give it a go. Being brave and talked out of a GA, I gave it a go. It was horrific. I have a real issue with things being put where I can't see and it was painful, especially when the electric shocks (?) started on one of my legs. In tears, I asked for a GA. I was told it was very near to being ready and I agreed to keep going with the spinal but after the second electric shock and me in complete panic mode, I begged for a GA and the lovely, wonderful nurse who held me throughout was fierce with the anaesthetist and insisted she stop and give me a GA. That nurse was an absolute angel and held me throughout. I'm now in absolute agony with pain in my leg. Not my surgery site - that's fine!

Back on the ward in a single room, I was left for over two hours without being asked if I wanted drink and food. I eventually buzzed to ask. I had obs done on the recovery unit but not since I've been back in my room and its now five and a half hours after surgery and theres only been two brief visits to me as I buzzed to use the loo with assistance. I waited for painkillers for an hour (not nurses fault at all, she's so busy) and my own tablets haven't been taken care of despite someone earlier saying they'd let the senior nurse know about them.

My details whiteboard hasn't been filled out (dont know if that matters) and the blinds in my room have blinds missing so no doubt across the way has seen my knickers and bare boobs several times.

Staff are absolutely lovely on the ward. They're They're doing their best but I can tell they have very little to give. They need my bed more than I do for a bloody good rest! They're run ragged. AIBU to expect our NHS to invest in staff and their wellbeing so they can care for patients better?

It’s no good demanding more doctors when there’s no money to pay them

I think a lot of trade unions are harmful and use their voice to push preferred ideologies of their management teams rather than represent their members. But do you really think Labour are going to try and dismantle unions? If so, I have a bridge to sell you.

So pop has gone up by approaching a half - has there been a 50 % increase in the number of hospitals across the land, No. a 50 % increase in the number of doctors and nurses no but they’ve probably gone up a bit.
But overcrowded A/Es across the land demonstrate an acute shortage due to increased population

It’s been a gradual process, despite increasing amounts of money thrown at it. It’s just an inefficient monolith that needs root and branch reform. As does the social care system. 🤷‍♀️

Add to that the far greater number of things that get treated on the NHS that didn't before, and new drugs and treatments available.

When in doubt, blame Brexit. It's run like councils and universites - nonsense unnecessary job titles, top heavy overpaid senior management and an inability to allocate funds appropriately. Throw as much money at it as you like, it will just be wasted.

This.

The usual ignorance that some people love to spout, overlooking the fact that without immigration the NHS would not even be.

Palantir could probably streamline bookings and also check on staffing absences etc and produce data useful for changes eg GPs working part time to avoid going into next tax bracket, I can see that people worry about privacy but once you are online and shopping isn’t your name, postcode, likes,dislikes etcetc out there anyway?

I fear you are correct. What a shame.

Without immigration the government might have been forced to negotiate with the classes that do the work earlier. Why on earth would anyone want to pay £10k a year tuition fees to work placements where they’re supposed to be supernumerary learners but are in fact essential hands-on on poorly staffed wards? And then graduate to find there’s no jobs because the government hired a load of foreigners on cheaper wages? The boomers who are predominantly being cared for would not pay to work! I know loads of perfectly good healthcare staff who will no longer consider progress onto nursing because it’s an impossible situation. The lack of progression and more demands on minimum wage then makes everyone constantly look around for jobs elsewhere. The churn between schools, nurseries and hospitals and a few in transport is remarkable at the moment.

I think a hell of a lot of staff walked out after Covid, between poor working conditions and what they saw then, and the government took the opportunity to hire a load more cheaper staff - certainly in my local hospital there was a big influx then.

Nonsense. Without immigration the population would be 12 million people smaller (also considering it was recently noted that half of immigrants live in poverty so are a net drain on the country). Without immigration there would be exactly the same number of specialty trainees but they would all be UK trained doctors who get to stay in the UK rather than being forced to emigrate. Without immigration the nurses and midwives who graduated last year in wales would have found employment. Ditto physiotherapists.

Victim of its own success x underfunding x badly run. A tangle of many problems rather than a single one.

One of the hidden problems - people management, especially the management of management.

eg - with fixed wages and no bonuses for the majority of staff there is no tangible incentive to do a great job. Doing well wont get you extra money or a better job or even better job security. Doing badly is fine, it’s almost impossible to get fired.

eg - recruitment. Everything rests on the interview, your previous experience/proven achievements matter for nothing as long as they meet the minimum requirements for the job. Good interviewees do better, regardless of of actual proven ability.

I could go on.

Sorry you had that experience. I had the opposite re GA where I wanted sedation and they insisted on GA for their medical reasons. They don’t do them lightly as they carry more risks, obviously.

I have very mixed experiences w the NHS. Seen some great consultants, others have been patronising and dismissive. A&E very hit and miss.

Last time I went (after a horrible incident), they were great w tests/treatment but communication was a bit rubbish.

The NHS (even in its current state) is amazing.

Try going to the USA, where being tens of thousands of pounds in medical debt is almost the norm.

People in the UK don’t die because they can’t afford Insulin, or can’t afford Chemo.

The waiting list is the price we pay for a Universal Healthcare Service.

Mum had a stroke a couple of years ago, the ambulance was there in 30 minutes, She was taking to a regional centre of excellence and treated ny highly qualified professionals, using state of the art equipment, she was then transferred to a local hospital where she worked with physio, speech and langague etc - never once was money an issue in treatment.

Twice over the last 2 years I’ve been investigated for Cancer - both times seen be a Consultant, had an Op / Biopsy, and had my results in less than 12 weeks.

Childhood Vaccinations - anyone not able to afford them? Medication for children .. anyone unable to afford it ? (In other country’s children die of preventable / treatable illnesses every day)

I ring my GP and am anyways triaged on the same day.

The NHS isn’t filled with “middle managers doing nothing” it’s a helpful line trotted about by Goverments who don’t want to invest in the NHS. We have an aging population (and cuts to social care has meant more hospital admissions). We have people with complex conditions who probably would have died at a younger age, who need looking after. We have higher expectations (famous cases of £1.2m per injection), and we have drug companies who know they can demand that amount.

If I was involved in a serious accident I would not be left dying at the side of the road, emergency services would come and put me back together.

The NHS is amazing.

Did they offer you sedation with the spinal, OP?

I've had 2 procedures with spinal + sedation, and it was brilliant. I barely felt it going in and I was no more aware of what was going on than I was under GA. When I woke up, I felt bloody fantastic: no befuddled feeling and none of the nausea/vomiting I get with a GA. I just felt as though I'd had the best night's sleep ever and I was ravenously hungry.

Where it's an option, I'd always go for that again. I'm not sure I'd like epidural without sedation though, I think the noises and smells of surgery might be a bit unpleasant.

I’m afraid I’ve lost all sympathy with the staff. I haven’t been on or in award recently where I’ve seen staff doing much more than what I would consider to be the bare minimum. There’s been an awful lot of chatting, an awful lot of standing round and/or doing things two or three times that didn’t need doing in the first place.
The NHS is broken and the root of the problem is the staff attitude to their jobs. Sadly, many of them see it as a cash cow and don’t understand that it’s taxpayers money that they’re wasting when they stand around not doing an awful lot.
I’m sure they worked incredibly hard during Covid but that was years ago and we do really need to get back to some sort of standard that is acceptable and not a waste of money.

How rapidly? Since Burnham got in or just since Starmer?!

You're very selective in your blame. No blame for the 14 years of Tory government eh?

They did work hard during Covid and they also had a blank cheque for overtime payments. More wasted money - under the Tories.

It's always been crap..envy of the world my arse. Social insurance models are the way to go. Real funding has increased since 2010

PPP and PPI were the brainchild of John Major's Conservative government, with the first contracts being signed in 1991. When Labour and Blair came to power in 1995 they inherited the contracts signed by Major which would have cost more in penalties to cancel than it cost to continue the projects.

These contracts are not financed through loans - that's the whole point of them. Private businesses build the facilities and charge the government for their use. The issues arise when people realise that although the use of PPI results in a short-term saving, in the long term these contracts are hugely expensive as the providers have proven to be far better at negotiating than the government and the civil servants.

and sadly died so I’m not sure I’d actually begrudge them that; it’s what’s happening now that is disaster.

I totally agree with this.

Since Shipman and then the Liverpool Pathway scandals HCPs are frightened to not keep prolonging life for fear of complaint from angry relatives who want every possible treatment.

My DM has late stage vascular dementia (bedbound, doubly incontinent, doesnt know who she is let alone who anyone else is) yet she is still being treated with ABs for chest infections. I am trying to stop this except my DB falls into the 'angry relative' category.

My view is that post age 75 all treatment should be focused on immediate comfort rather than extending life. To this end I am going a bit further with an Advance Directive to say that if I am diagnosed as having permanently lost capacity I want all treatment to stop. I would far rather go a few years too early than a few years too late.

Absolutely not true about the uptick in junior Dr strikes. One strike compared to numerous under Tory.